Question 1

What is HCPCS code Q0221?

Accepted Answer

HCPCS code Q0221 is "Tixagev and cilgav, 600mg". Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg

Question 2

What category is Q0221 in?

Accepted Answer

Q0221 belongs to HCPCS Category Q (Temporary Codes).

Question 3

When should I use HCPCS code Q0221?

Accepted Answer

Use Q0221 when billing for tixagev and cilgav, 600mg. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is Q0221 covered by Medicare?

Accepted Answer

Coverage for Q0221 (Tixagev and cilgav, 600mg) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for Q0221?

Accepted Answer

Documentation for Q0221 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).